Provider Demographics
NPI:1336387216
Name:GRIFFITH, CATHERINE RUSSELL (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:RUSSELL
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 SUNFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77713-9299
Mailing Address - Country:US
Mailing Address - Phone:409-866-2406
Mailing Address - Fax:
Practice Address - Street 1:604 FM1233
Practice Address - Street 2:
Practice Address - City:KOUNTZE
Practice Address - State:TX
Practice Address - Zip Code:77625
Practice Address - Country:US
Practice Address - Phone:409-246-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist